白内障超声乳化术后盘周视网膜神经纤维层厚度及黄斑视网膜厚度与视力相关性研究  

CORRELATION BETWEEN VARIATION CHARACTERISTICS OF PATIENTS' RETINAL NERVE FIBER LAYER THICKNESS AND MACULAR RETINAL THICKNESS AND VISUAL OUTCOME FOLLOWING PHACOEMULSIFICATION OF CATARACT

作　　者：孙冉[1] 张舰[1] 刘大川[1] 方薇[1] 杨惠清[1] 唐一杰[2] 

机构地区：[1]首都医科大学宣武医院眼科,北京100053 [2]华北电网有限公司北京电力医院呼吸科,北京100073

出　　处：《河北医科大学学报》2014年第10期1152-1155,共4页Journal of Hebei Medical University

基　　金：北京市委组织部优秀人才资助项目(20051D0501821)

摘　　要：目的应用光学相干断层扫描仪(optical coherence tomography,OCT)定量测量眼底盘周视网膜神经纤维层(retinal nerve fiber layer,RNFL)厚度以及黄斑视网膜厚度的变化,了解白内障患者施行超声乳化(phacoemulsification,Phaco)吸除手术后盘周RNFL厚度以及黄斑视网膜厚度变化特点与视力的相关性。方法选取在首都医科大学宣武医院眼科确诊为年龄相关性白内障患者49例(70眼),分不伴有糖尿病患者为正常组29例(38眼),伴有糖尿病患者为糖尿病组20例(32眼),成功施行白内障Phaco联合人工晶体植入手术,利用OCT定量测量Phaco手术后不同时间(包括术后3d、2周、1个月、3个月、6个月)眼底盘周RNFL厚度和黄斑视网膜厚度,对比不同时间点RNFL厚度和黄斑视网膜厚度变化,探讨上述指标与术眼最佳矫正视力(cotrected visual acuity,CVA)的相关性。结果正常组术后2周、1个月、3个月盘周RNFL厚度与视力呈负相关(r=-0.466、-0.490、-0.511,P<0.01);正常组术后2周、1个月黄斑视网膜厚度与视力呈负相关(r=-0.309、-0.315,P<0.05)。糖尿病组术后2周至术后6个月盘周RNFL厚度与视力呈负相关(r=-0.365、-0.447、-0.512、-0.499,P<0.01);糖尿病组术后3d至术后6个月黄斑视网膜厚度与视力呈负相关(r=-0.427、-0.490、-0.653、-0.451、-0.353,P<0.01)。结论白内障Phaco术后黄斑视网膜厚度的改变是影响视力变化的主要原因,同时白内障Phaco术后盘周RNFL厚度也在不同时期、不同程度地对视力造成着影响。Objective Optical coherence tomography （OCT）was used to quantitatively measure of peripapillary retinal nerve fiber layer （RNFL）thickness and the change of macular retinal thickness,understanding of correlation between the variation characteristics of patients′RNFL thickness and macular retinal thickness and visual outcome following Phacoemulsification （Phaco）of cataract patients.Methods Forty nine patients （70 eyes）diagnosed with age-related cataract,in Xuanwu Hospital,Capital Medical University,were divided into two groups,patients with diabetes in the diabetes group,20 cases （32 eyes）,not with diabetes in normal group,29 cases （38 eyes）,the cataract combined with phaco intraocular lens implantation operation was＆amp;nbsp;successfully implemented,the peripapillary RNFL thickness and macular retinal thickness changes were analyzed by means of OCT after Phaco operation at different time points （including 3 days,2 weeks,1 month,3 months,6 months after operation）,to discuss correlation between the above indexes and postoperative best corrected visual acuity（CVA）.Results In normal group,the peripapillary RNFL thickness showed statisticly negative correlation with CVA at the time 2 weeks,1 month,3 months after operation（r-0.466,-0.490,-0.511,P〈0.01）;In normal group,the macular thickness showed statisticly negative correlation with CVA at the time 2 weeks,1 month after operation（r=-0.309,-0.315,P〈0.05）respectively.In diabetic group,the peripapillary RNFL thickness showed statisticly negative correlation with CVA in 2 weeks to 6 months following surgery（r=-0.365,-0.447,-0.512,-0.499,P〈0.01）;In diabetic group,the macular thickness showed statisticly negative correlation with CVA in 3 days to 6 months following surgery（r=-0.427,-0.490,-0.653,-0.451,-0.353,P〈0.01）.Conclusion The macular retinal thickness in Phaco patients after cataract is the main reason that affects the vision,at the same time cataract after Phaco peripapillary RNFL thickness has impact on visu

关 键 词：白内障 视神经 超声乳化白内障吸除术 

分 类 号：R776.1[医药卫生—眼科]